Active NPI
Aimee Mahoney, M.S, CCC-SLP
- Speech-Language Pathologist
- Palm Coast, FL
National Provider Identifier
1245530765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA11599
- Practice address
- 4875 Palm Coast Pkwy NW
Suite 2
Palm Coast, FL 32137-3670 - Phone
- (386) 446-9935
- Fax
- (386) 446-7777
- NPI assigned
- Nov 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA11599 | FL | Primary |
Addresses
Primary practice location
4875 Palm Coast Pkwy NW
Suite 2
Palm Coast, FL 32137-3670
Mailing address
64 Rollins LN
Palm Coast, FL 32164-6947
Phone (352) 359-1725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA11599 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Place to Grow Pediatric Therapy | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Palm Coast, FL
- NPI 1972023620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1245530765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 ROLLINS LN",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321646947",
"telephone_number": "352-359-1725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4875 PALM COAST PKWY NW",
"address_2": "SUITE 2",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321373670",
"telephone_number": "386-446-9935",
"fax_number": "386-446-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "AIMEE",
"credential": "M.S, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-01",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA11599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.